Biomechanical comparison between rim plating and posterior buttress plating for posterolateral tibia plateau fractures

This study aimed to compare the biomechanical efficacy of rim plating versus conventional posterior buttress plating for fixing posterolateral tibial plateau fractures (PLTPFs). Sixty synthetic tibial models were divided into three groups: posterior buttress plating with a 3.5-mm locking compression T-plate, rim plating with a 2.7-mm variable-angle cloverleaf plate and two anteroposterior screws, and rim plating alone. Static compression and cyclic loading tests were conducted to assess mechanical stability under simulated physiological conditions. Failure loads averaged 2235.75 N, 2017.46 N, and 1743.95 N for the three groups, respectively, all exceeding the 1500-N threshold corresponding to approximately 250% of body weight. Cyclic loading exerted minimal displacement across groups, with no significant differences in stability. Rim plating demonstrated slightly lower failure loads than traditional posterior buttress plating but provided sufficient biomechanical support for PLTPFs. Its performance under static and cyclic loading indicates its feasibility as an alternative that offers adequate stability while potentially reducing surgical invasiveness. These results suggest that rim plating is a biomechanically viable alternative for the management of PLTPFs, offering adequate stabilization with the potential advantage of reduced surgical invasiveness.